Unique Program Aspects
- Training Sites
- Special Courses and Rotations
- Resident Committees
- Advising and Mentoring
- Teaching Opportunities
|Duke Children's Hospital and Health Center
The major site of training is Duke Children's Hospital & Health Center, located within the Duke University Medical Center in Durham, North Carolina. Duke Children's Hospital serves as both a primary care facility and a referral center for patients from North Carolina and throughout the Southeast. Each year, there are over 5,000 inpatient pediatric admissions, 3,000 deliveries, and 176,000 pediatric ambulatory visits.
|WakeMed Health and Hospitals
WakeMed Raleigh provides a wonderful community hospital experience for Duke residents where they work alongside UNC residents to care for patients in the inpatient, outpatient and ED setting. WakeMed is located in Raleigh about 30 minutes from Duke Hospital. In a new children’s hospital built in 2010, WakeMed Children’s offers 25 inpatient rooms, 12 observation rooms, and eight pediatric ICU beds. Residents are under the supervision of seven superb hospitalists and intensivists in caring for the children of Wake County and serving as a referral center for the surrounding counties.
|Lenox Baker Children’s Hospital (LBCH)
Lenox Baker Children's Hospital (LBCH) is a part of the Duke University Medical Center and serves as a multidisciplinary rehabilitation center for children with disabilities or those with chronic illnesses. In addition to the rehabilitation center, residents participate in various specialized clinics (e.g., autism clinic, scoliosis clinic, myelodysplasia clinic, dental clinic, Trisomy 21 clinic, orthopedic clinic, and ophthalmology clinic) while on this rotation in Neurodevelopmental Pediatrics.
|Lincoln Community Health Center (LCHC)
Lincoln Community Health Center (LCHC) is located in downtown Durham near North Carolina Central University. It serves as the main provider of healthcare for Durham’s medically underserved community. The clinic offers a range of health care services, including medical, surgical, nutritional, dental, social, mental health, family care nursing, OB-GYN, and "Teen Clinics." The Pediatric Clinic at Lincoln is a primary care pediatrics facility. Upper level residents serve an essential role in the clinic at Lincoln, operating independently with support from attending pediatricians.
Duke Pediatric Research Scholars Program for Physician-Scientist Development (DPRS)
The Duke Pediatric Research Scholars Program (DPRS) is a Physician-Scientist Training Program (PSTP) dedicated to preparing burgeoning physician-scientists for careers in academic medicine. The program focuses on the period from the completion of the MD, DO, MD/PhD, or DO/PhD degree through residency and fellowship training, with the goal of achieving a full-time academic appointment as an investigator. DPRS combines the intensive clinical training environment of Duke Children’s with the rigorous scientific training of the world-renowned laboratories at Duke University.
The Duke Department of Pediatrics is proud of its rich community of physician-scientists, and the Duke Pediatric Residency and Medicine-Pediatrics Residency Programs are fully supportive of research-enhanced training. The Duke Pediatric Research Scholars Program for Physician-Scientist Development is tailored to meet the unique professional goals and interests of physician-scientist trainees by providing three distinct research pathways to select from, including the Traditional Pathway and the American Board of Pediatrics (ABP)-approved Integrated Research Pathway (IRP), and Duke's R38 SCI-StARR Pathway.
The advocacy and community pediatrics outreach rotation is designed to enhance resident education by providing pediatrics residents with exposure to a wide variety of community health education, home needs assessment, and pediatric advocacy experiences that are specifically targeted toward the urban underserved population residing in Durham County. Residents accompany community health workers on home visits for high-risk patients, teach health classes to local at-risk preschool, elementary and high school children and participate in visits to the North Carolina General Assembly when in session. In addition, residents participate in a variety of self-paced modules covering poverty, oral health, motivational interviewing and advocacy topics.
Some of the specific experiences include:
- Reach Out and Read
Reach Out and Read is a nonprofit organization that gives young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together. Our faculty and resident leaders are involved in maintaining this program in our clinic sites. All residents are involved in promoting the Reach Out and Read message to the patients they care for in their clinics.
- Healthy Lifestyles and Bull City Fit
During their community and advocacy rotation, residents are engaged in the Healthy Lifestyles Program, a multidisciplinary clinic for overweight patients, and Kohl's Bull City Fit, a partnership created through a joint use agreement with Durham Parks and Recreation to provide a free wellness program for these patients and their families. Because it is difficult to effectively teach the principles of building and sustaining community relationships within the constraints of a one month rotation, Bull City Fit is used as a model for the residents as they maintain oversight during their month and are involved in everything from volunteering with the children’s exercise classes to program planning and development.
- Resident Outreach in Community Obesity Prevention (ROCOP)
The Resident Outreach in Community Obesity Prevention (ROCOP) project aims to educate the at-risk preschool population of Durham about healthy nutrition and physical activity. The aim of the program is to increase education in the early childhood setting to prevent the onset of childhood obesity. The preschool age group was specifically chosen based on data from Durham’s Partnership for Children, which indicates children between the ages of two to five have an increased incidence of not receiving well child care. As a result, by the time they return for kindergarten physicals, many are already overweight. Building on the principles of advocacy and utilizing family-centered communications techniques, residents conduct outreach work to impact this target population. Specifically, the residents focus their outreach efforts on the North Carolina Division of Public Health's "Eat Smart, Move More" message of "5-3-2-1-almost none," a child-friendly and evidence-based teaching tool that highlights healthy eating and exercise.
- Carolinas Collaborative: Community-Pediatric Partnerships for Promotion of Child Health and Prevention of Toxic Stress
With the guidance and support of the American Academy of Pediatrics’ Community Pediatrics Training Initiative and recent funding from the Duke Endowment, the Duke Pediatrics Residency program is actively involved in creating the Carolinas Collaborative--a North and South Carolina residency advocacy collaborative that will support 8 pediatric residency programs. All of the programs will be involved with advancing community-based interventions that aim to ameliorate the effects of toxic stress in their communities. The Duke community partnership project will be with Durham Connects.
- Durham Connects
Durham Connects increases child well-being by bridging the gap between new parent needs and community resources. A collaborative effort among the Duke Center for Child & Family Health, Duke Center for Child and Family Policy, Department of Social Services, and Durham County Health Department, Durham Connects hires and trains nurses to provide in-home health assessments of mothers and newborns, as well as discuss the social conditions affecting the new family. Nurses make a first visit when the baby is about three weeks old, with the goal of connecting new parents with the community resources they need to raise a healthy child. Through the community pediatrics and advocacy rotation and with recent funding from the Duke Endowment, the Duke Pediatrics Residency program is embarking on a new collaboration with the Durham Connects group. While this is an actively evolving project, this collaboration will involve a second visit to the family at 12 months where a Duke pediatric resident will accompany a Durham Connects’ nurse to perform a follow-up home visit. This visit will focus on supporting positive parenting skills, promoting early literacy and assessing current needs of the family resulting in referrals to appropriate community resources. The aim is to address toxic stress by using these visits to identify parental strengths and promote parental self-efficacy and self- confidence in parenting skills.
- Ronald McDonald House
The Ronald McDonald House of Durham & Wake offers a comforting home away from home and a community of support for seriously ill children and their families. Residents have the opportunity to interact with and support patient families in an informal environment while their children are receiving medical treatment at Duke.
Child Abuse Rotation
Residents work with the physicians and social workers to assess suspected victims of child abuse and neglect. The residents observe interviews with patients and families, participate in the physical examination, and attend conferences and legal proceedings, when appropriate. Most residents will spend two to four weeks in this rotation.
Cost-Conscious Care Curriculum
Approximately 30% of healthcare costs (more than $750 billion annually) are spent on wasted care. This wasted care is potentially avoidable and would not negatively affect the quality of care if eliminated. The Duke Pediatric Cost-Conscious Care Curriculum is a novel series of didactics incorporated into resident morning report that challenges residents to devise appropriate and cost-conscious evaluations for specific pediatric cases. It is derived from the American College of Physicians’ High-Value, Cost-Conscious Care curriculum for Internal Medicine and is funded by a Duke GME Innovation grant.
Evidence-Based Medicine (EBM)
Evidence-based Medicine is woven into multiple facets of resident education in order to emphasize it as a method of continuous learning, rather than an isolated set of skills. There are specific EBM journal clubs held throughout the year. During these sessions, a senior resident leads the group through the evidence-based cycle of assessing a patient, asking a clinical question, appraising the evidence, and applying the evidence back to the patient. Each presenter will choose a different EBM concept to emphasize in a brief didactic talk at the end of the session.
Core topics covered by the EBM curriculum include:
- Formulating a clinical question using PICO
- Systematic Reviews
These core concepts are then applied throughout residency training. In particular, at the conclusion of every morning report, the resident who presented the case then poses and answers a pertinent clinical question with supporting evidence. Additionally, senior residents on the wards are encouraged to identify a clinical question for each admitted patient. They then use the medical literature to answer their question in a senior note and share this information on daily rounds.
Global Health Rotation
The Duke Pediatrics Residency training program is committed to providing opportunities to allow our trainees to become globally experienced, socially responsible, service-oriented citizens so that they may make a lifelong commitment toward reducing the burden of disease and health inequalities. Our current programs support residents for short-term global health electives for one to two months. This immersion experience allows our residents to experience clinical care and occasionally research projects in other countries. Opportunities exist in many sites where Duke has long-term commitments including Central and South America, sub-Saharan Africa, Southeast Asia, and Australia.
History of Medicine Elective
This is a one-month elective where residents develop a deeper understanding of the major themes in the history of American Pediatrics. A general pediatrician with a doctorate in history mentors residents as they conduct a literature search to explore the historical background of a particular area of interest.
Newborn Care Rotation
The newborn rotation is an elective that can be taken as part of parental leave. The focus of the rotation will be on normal newborn care and resources in the community available to babies and their parents. The rotation will be up to one block in length and will be free from call and weekend duties. Residents on the rotation still attend their weekly continuity clinic.
Schwartz Center Rounds
Schwartz Center Rounds is a monthly interdisciplinary conference that offers clinicians a regularly scheduled time during their fast-paced work lives to openly and honestly discuss social and emotional issues that arise in caring for patients. An initiative of the Schwartz Center for Compassionate Healthcare, the rounds take place at 250 sites in the U.S. and U.K. including many of Duke’s peer institutions (Massachusetts General Hospital, Brigham & Women’s, Vanderbilt, Mount Sinai, Emory, Cleveland Clinic and UNC-Chapel Hill).
In contrast to traditional medical rounds, the focus of the Schwartz Rounds discussions is on the human dimension of medicine. Clinicians have an opportunity to share their experiences, thoughts and feelings on thought-provoking topics drawn from actual patient cases. The premise is that clinicians are better able to make personal connections with patients and colleagues when they have greater insight into their own responses and feelings.
SCOPE: Teaching Outside the Box
The “SCOPE” of pediatric medical education extends beyond the diagnosis and treatment of individual patients. In addition to medical knowledge and patient care, pediatric residents are expected to demonstrate competency in interpersonal skills, communication, professionalism, and systems-based practice. Our graduates are expected to have a solid understanding of the financial, ethical, legal, and professional obligations of providing medical care in a safe environment. The Duke Residency Training Program has designed the SCOPE curriculum to address these important “non-traditional” learning goals.
SCOPE sessions occur two afternoons each month for residents on elective rotations. The sessions are small group seminars in which Duke faculty members from various departments facilitate group learning. In addition to faculty facilitators, sessions incorporate standardized patients, legal experts, and core safety team members. The SCOPE curriculum incorporates the following elements:
Safety and Risk Management
Communication and Teaching / Cultural Competency
Operational Finance and Business of Medicine
Advocacy & Community Council for Trainees (ACCT)
The Advocacy & Community Council for Trainees (ACCT) is a resident-led organization with strong faculty support. Their overarching goal is to advocate for our community’s children: their health, safety, and future. They aim to provide pediatricians in training with resources and skills to serve our community as well as provide services to children and families in need. Above all, ACCT puts kids first and aim to be a voice for our community’s children. The group works closely with the American Academy of Pediatrics on advocacy efforts and organizes monthly meetings with guest speakers whose work is pertinent to our mission. They help educate through a monthly, informal journal club (Evidence Based Advocacy) and a blog. ACCT focuses on using this knowledge to improve our community, our state, and our world for children.
Pediatric Residency Safety Council (PRSC)
PRSC is a resident-led council supported by faculty and chief residents with a goal of being recognized as leaders in patient safety and fostering a culture of safety across the residency program. The council works to educate and engage fellow residents on quality improvement, process improvement, and patient safety. The PRSC organizes monthly morbidity and mortality conferences and reviews safety reports. More than 30 action items have been completed by the PRSC since its establishment in 2013. Council members have presented posters at multiple local, regional, and national conferences and have received recognition for their work. The PRSC provides a model for patient safety across graduate medical education at Duke.
Resident Wellness Committee
The Resident Wellness Committee is a resident-initiated group that is committed to advocating for resident wellness at the level of the individual and the institution through innovative curriculum changes, educational conferences, and other activities inside and outside of the workplace. The committee meets monthly to develop curriculum and plan initiatives.
Resident Diversity and Inclusion Committee
The Resident Diversity and Inclusion Committee partners with program and leadership to foster a welcoming environment in alignment with the Department of Pediatrics' mission. The group is committed to achieving equity in health outcomes for all children through outstanding clinical care, advocacy efforts, and educational excellence. The committee meets monthly to plan new initiatives to support our mission, such as holding meetings with the Duke Student National Medical Association (SNMA), organizing social events like our annual BBQ, and pursuing opportunities to reach out to our community such as our partnership with the Durham LEAP program.
Upon entering the program, all Duke Pediatric residents are assigned an advisor from within the Duke Pediatrics Graduate Medical Education (GME) team. Program advisors meet with residents at least twice a year to review their progress, provide feedback, create an individualized curriculum, and assist with optimizing their educational endeavors at Duke. Residents and advisors establish relationships that continue over all three years of their training.
All residents are also assigned a mentor, who is selected to meet the individual needs of each resident, as identified by the resident and their advisor. The mentor ensures that the resident meets his or her specific mentoring needs, which may include general career counseling in a given specialty or participation in a research project. Residents may have more than one mentor, depending on their evolving training and mentoring needs.
Training physicians who can share their skills with other learners is an important part of our education at Duke Pediatrics. There are many opportunities for learning these skills that residents are presented with throughout residency.
Teaching and Feedback Workshops
- Rising second years participate in a workshop on setting personal goals for teaching, applying basic adult learning principles, practicing the five Microskills of Clinical Teaching, learning bedside teaching strategies, practicing effective feedback, and identifying team leadership skills.
- Rising third years participate in a workshop on understanding the learning needs of students and interns, identifying strategies to incorporate more teaching into clinical practice, and practicing effective feedback.
Resident as Teacher Elective
- Second and third year residents can choose this two week elective.
- Residents are given a structured and individualized curriculum to augment their teaching skills in various clinical settings.